BACK PAIN AND SEX (adapted for HNP)

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1 ORTHOPAEDIC SPECIALISTS 902 N Howe Street Southport, NC (910) BACK PAIN AND SEX (adapted for HNP) People with low back pain are typically told how to lift, sit, bend, and exercise, but rarely are they advised on how to make love. Because sex can be as important as other activities but sometimes difficult to talk about, we have prepared this booklet. In this way we hope to present safe, comfortable alternatives and answer questions which are often never asked. Decreased sexual activity is not uncommon in people with low back pain. Pain can quickly kill arousal. Anticipation of the pain can be equally as effective in limiting the mood. Sometimes it seems better not to start something which might not be possible to finish. Physical changes that limit positioning can curtail the use of position that you have previously enjoyed. A partner s concern for your comfort and safety can also be a limitation. Often a partner will assume that sex will precipitate an increase in pain rather than pleasure. Partners sometimes believe that because you can t work, lift, or sit too long, you can t have sex. It is easy to understand how a partner could assume that you just aren t interested in sex right now and that you are too miserable to enjoy it. Unfortunately, a considerate partner s misconceptions about your abilities and desires can lead him or her to thoughtfully ignore you sexually. That can easily result in feelings of rejection which complicates the problem even more. I general the anxiety that results from a low back problem can also decrease sexual desire. Being out of work can change your financial status, sometimes drastically and that can decrease feelings of self-worth which can affect your libido. This altered life style can also demand role changes and cause personal relations to be stained. When this happens your desire for each other can drop considerably. The good news is that love making can be therapeutic for your low back pain. There are indications that your body increases production of its natural pain killers during arousal and orgasm. Good sexual relations can improve your feelings about yourself. This is one area of your relationship that does not have to be strained and sex can make the other areas of stress easier to tolerate. A little planning can make your sexual experience much more pleasurable. If you have a time during the day which is typically the most pain free then plan for sex during that time. Get up earlier in the morning, arrange a long lunch break, or send the children to a baby sitter during your weekend prime time. Just before sex, avoid activities that usually increase pain. Don t go for a long drive or clean out the refrigerator. Rather, take time to relax before you make love. Take a warm shower, indulge in some mutual massage with warm lotion, snuggle up and talk about things that make you happy and content. Time your pain medication so that you take it minutes before your planned tryst.

2 Enjoy slow, gentle love making. Minimize rough movement and abrupt changes of position. Let your partner be the more aggressive one. Choose positions that are most comfortable during other activities and use then during sex. Accept that what you are used to might not be comfortable and find something better. Take time to browse through the pictures the pictures in this booklet. There are many pleasurable alternatives. There may be circumstances in which bringing penis and vagina together is painful in any position. There are also pleasurable alternatives to this old standby. You can arouse and bring each other to orgasm by using your hands to fondle and caress each other, either simultaneously or in turn. Explore the sensitive areas of each other s bodies by kissing, licking, sucking, and nibbling. A hand held vibrator can be enjoyable, especially when lightly held to sensitive areas such as the under side of the penis or the clitoris. willingness to explore and compromise are. The needs and desires of each partner are not always obvious to the other. Particularly when trying new sexual techniques it is important to tell each other what is p l e a s u r a b l e a n d w h a t i s n o t. Communication is easier if both partners speak the same language. It is important to establish verbal and nonverbal signals that indicate pleasure, pain or dislike for what is currently happening. It is also important to establish a vocabulary for sexual techniques and body parts. This vocabulary can be either standard or personal but it needs to be used often so that it will not seem awkward to use during a sexual encounter. Sex can be as much a part of the human experience as eating and drinking. If it is an activity in which you are interested, there is no reason to limit yourself. Relax, experiment, and enjoy the possibilities. Sexual stimulation can still be beneficial even if there is no partner available. Self stimulation is healthy and normal behavior and can enhance sexual response with a partner. Exploring your own body and finding out which kinds of stimulation work best for you can make your next sexual experience more satisfying. Sexual pleasure can be enjoyed with or without erection and orgasm. The physical and emotional benefits of sexual intimacy are not dependent on orgasm. The contentment that can result from mutual stroking, kissing, and close physical contact can be more than satisfactory. An erection is not a requirement for a couple s sexual fulfillment. Consideration and attention to each other s needs and desires as well as a

3 LYING ON BACK WITH KNEES BENT LYING ON BACK WITH KNEES BENT The woman lies on her back, knees together, with a pillow under hips and thighs. Notice that the male partner is supporting his own weight on his hands and knees. this can be used when the woman has hip and knee involvement or is able to move her legs apart. Can use lumbar support or pillow under hips for pelvic tilt Woman above across both thighs Weight supported, woman s thighs outside Woman above between his thighs

4 Man with low back pain may be more comfortable with one leg elevated on a stool. Women with a herniated disc should not be in this position Person with low back pain has one leg on floor or stool and the other knee supported on the bed Both partners are standing and the man enters from behind. The woman uses furniture at a comfortable height for support and balance. The woman with a herniated disc should NOT be in this position

5 IF LYING ON YOUR STOMACH IS COMFORTABLE FOR YOU - WOMEN IF LYING ON YOUR STOMACH IS COMFORTABLE FOR YOU - MEN Woman above between his thighs Man on top across her thighs Woman above across his thighs

6 IF SIDE-LYING IS COMFORTABLE FOR YOU The woman is kneeling, her upper body supported by furniture. Her knees can be supported by a pillow Side position with partners facing each other. Can be used if man has back involvement. The man lies on his back. He may use pillows for support. The woman supports her own body weight on her elbows and knees. Both partners lying on side, the man enters from behind. the woman can have a pillow between her knees His thighs outside Man lies on his side. The woman lies on her back, knees flexed.

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